Skip to main content

Addressing Behavioral Cancer Risks from a LGBT Health Equity Perspective

  • Chapter
  • First Online:
Cancer and the LGBT Community

Abstract

Accounting for individual, community, and societal factors, as well as historical context and life-course events, we utilize a Health Equity model to consider behavioral risks and identify social determinants that may influence cancer risks in LGBT populations. Based on data from available research, we provide estimates of the prevalence of behavioral risks in LGBT communities, including excessive drinking and substance abuse, obesity, poor nutrition and diet, and physical inactivity. Both upstream and downstream factors that may elevate such behavioral risks for cancer among LGBT populations, including those unique to particular subgroups, are discussed. Examples of innovative programs and interventions designed for LGBT communities to target cancer-related behavioral risks are briefly described. We conclude with research, practice, and policy recommendations that are needed to promote health equity and reduce the disparate cancer burden in LGBT communities.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. U. S. Department of Health and Human Services. Healthy people 2020 objectives: lesbian, gay, bisexual, and transgender health. 2011. http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=25. Accessed 26. Oct. 2011.

  2. Centers for Disease Control and Prevention. CDC health disparities and inequalities report United States, 2011. MMWR 2011. 2011;60(Suppl):1–116.

    Google Scholar 

  3. Wallace SP, Cochran SD, Durazo EM, Ford CL. The health of aging lesbian, gay and bisexual adults in California. Los Angeles: UCLA Center for Health Policy Research; 2011 Contract No.: PB2011-2.

    Google Scholar 

  4. Fredriksen-Goldsen KI, Kim H-J, Barkan SE, Muraco A, Hoy-Ellis CP. Health disparities among lesbian, gay male and bisexual older adults: results from a population-based study. Am J Pub Health. 2013;103(10):1802–9.

    Article  Google Scholar 

  5. Dilley JA, Simmons KW, Boysun MJ, Pizacani BA, Stark MJ. Demonstrating the importance and feasibility of including sexual orientation in public health surveys: health disparities in the Pacific Northwest. Am. J Pub Health. 2010;100(3):460–7.

    Article  Google Scholar 

  6. Conron KJ, Mimiaga MJ, Landers SJ. A population-based study of sexual orientation identity and gender differences in adult health. Am J Pub Health. 2010;100(10):1953–60.

    Article  Google Scholar 

  7. American Cancer Society. Cancer facts for gay and bisexual men. Atlanta: American Cancer Society; 2013. http://www.cancer.org/healthy/findcancerearly/menshealth/cancer-facts-for-gay-and-bisexual-men. Accessed 17. Dec. 2013.

  8. National LGBT Cancer Network. The LGBT Community’s Disproportionate Cancer Burden. New York: National LGBT Cancer Network; 2013. http://www.cancer-network.org/cancer_information/cancer_and_the_lgbt_community/the_lgbt_communitys_disproportionate_cancer_burden.php. Accessed 17. Dec. 2013.

  9. Boehmer U, Miao X, Linkletter C, Clark MA. Adult health behaviors over the life course by sexual orientation. Am J Pub Health. 2012;102(2):292–300.

    Article  Google Scholar 

  10. Brandenburg DL, Matthews AK, Johnson TP, Hughes TL. Breast cancer risk and screening: a comparison of lesbian and heterosexual women. Women Health. 2007;45(4):109–30.

    Article  PubMed  Google Scholar 

  11. Case P, Austin SB, Hunter DJ, Manson JE, Malspeis S, Willett WC, et al. Sexual orientation, health risk factors, and physical functioning in the Nurses’ Health Study II. J Women’s Health (Larchmt). 2004;13(9):1033–147.

    Article  Google Scholar 

  12. Cochran SD, Mays VM. Risk of breast cancer mortality among women cohabiting with same sex partners: findings from the National Health Interview Survey, 1997–2003. J Women’s Health. 2012;21(5):528–33.

    Article  Google Scholar 

  13. Dibble SL, Roberts SA, Nussey B. Comparing breast cancer risk between lesbians and their heterosexual sisters. Women’s Health Issues. 2004;14(2):60–8.

    Article  PubMed  Google Scholar 

  14. Institute of Medicine. The health of lesbian, gay, bisexual, and transgender people: building a foundation for better understanding. Washington, DC: The National Academies Press; 2011. p. 347.

    Google Scholar 

  15. Zaritsky E, Dibble SL. Risk factors for reproductive and breast cancers among older lesbians. J Women’s Health (Larchmt). 2010;19(1):125–31.

    Article  Google Scholar 

  16. U.S. Cancer Statistics Working Group. United States Cancer Statistics: 1999–2010 Incidence and Mortality Web-Based Report. Atlanta: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, National Cancer Institute; 2013. http://www.cdc.gov/uscs. Accessed 17. March 2014.

  17. Sorensen G, Emmons K, Hunt MK, Barbeau E, Goldman R, Peterson K, et al. Model for incorporating social context in health behavior interventions: applications for cancer prevention for working-class, multiethnic populations. Preventive Med. 2003;37(3):188–97.

    Article  Google Scholar 

  18. Wilkinson RG, Marmot MG. Social determinants of health: the solid facts. Copenhagen: World Health Organization, 2003.

    Google Scholar 

  19. Centers for Disease Control and Prevention. Behavioral risk factor surveillance system. 2012. http://www.cdc.gov/brfss/. Accessed 24. Feb. 2012.

  20. Centers for Disease Control and Prevention. Other ways to reduce cancer risk. Atlanta: Centers for Disease Control and Prevention; 2013. http://www.cdc.gov/cancer/dcpc/prevention/other.htm. Accessed 17. Dec. 2013.

  21. American Cancer Society. Body weight and cancer risk. Washington, DC: American Cancer Society; 2013. http://www.cancer.org/cancer/cancercauses/dietandphysicalactivity/bodyweightandcancerrisk/body-weight-and-cancer-risk-effects. Accessed 18. March 2014.

  22. Fredriksen-Goldsen KI, Emlet CA, Kim H-J, Muraco A, Erosheva EA, Goldsen J, et al. The physical and mental health of lesbian, gay male, and bisexual (LGB) older adults: the role of key health indicators and risk and protective factors. Gerontologist. 2013;53(4):664–75.

    Article  PubMed Central  PubMed  Google Scholar 

  23. Fredriksen-Goldsen KI, Cook-Daniels L, Kim H-J, Erosheva EA, Emlet CA, Hoy-Ellis CP, et al. Physical and mental health of transgender older adults: an at-risk and underserved population. Gerontologist. 2013;53(4):664–75.

    Google Scholar 

  24. Meyer IH. Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: conceptual issues and research evidence. Psychol Bull. 2003;129(5):674–97.

    Article  PubMed Central  PubMed  Google Scholar 

  25. Wolford CC, McConoughey SJ, Jalgaonkar SP, Leon M, Merchant AS, Dominick JL, et al. Transcription factor ATF3 links host adaptive response to breast cancer metastasis. J Clin Invest. 2013;123(7):2893–906.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  26. Dawson DA, Grant BF, Stinson FS, Chou PS, Huang B, Ruan WJ. Recovery from DSM-IV alcohol dependence: United States, 2001–2002. Addiction. 2005;100(3):281–92.

    Article  PubMed  Google Scholar 

  27. Balsam KF, Rothblum ED, Beauchaine TP. Victimization over the life span: a comparison of lesbian, gay, bisexual, and heterosexual siblings. J Consulting Clin Psychol. 2005;73(3):477–87.

    Article  Google Scholar 

  28. Drabble L, Trocki KF, Hughes TL, Korcha RA, Lown AE. Sexual orientation differences in the relationship between victimization and hazardous drinking among women in the National Alcohol Survey. Psychol Addict Behav. 2013;27(3):639–48.

    Article  PubMed  Google Scholar 

  29. Hughes T, McCabe SE, Wilsnack SC, West BT, Boyd CJ. Victimization and substance use disorders in a national sample of heterosexual and sexual minority women and men. Addiction. 2010;105(12):2130–40.

    Article  PubMed Central  PubMed  Google Scholar 

  30. Alvy LM, Hughes TL, Kristjanson AF, Wilsnack SC. Sexual identity group differences in child abuse and neglect. J Interpers Violence. 2013;28(10):2088–111.

    Article  PubMed Central  PubMed  Google Scholar 

  31. Springer KW, Sheridan J, Kuo D, Carnes M. Long-term physical and mental health consequences of childhood physical abuse: results from a large population-based sample of men and women. Child Abuse Negl. 2007;31(5):517–30.

    Article  PubMed Central  PubMed  Google Scholar 

  32. Springer KW, Sheridan J, Kuo D, Carnes M. The long-term health outcomes of childhood abuse: an overview and a call to action. J Gen Internal Med. 2003;18(10):864–70.

    Article  Google Scholar 

  33. Bandini E, Fisher AD, Ricca V, Ristori J, Meriggiola MC, Jannini EA, et al. Childhood maltreatment in subjects with male-to-female gender identity disorder. Intern J Impot Res. 2011;23(6):276–85.

    Article  CAS  Google Scholar 

  34. Kelly-Irving M, Mabile L, Grosclaude P, Lang T, Delpierre C. The embodiment of adverse childhood experiences and cancer development: potential biological mechanisms and pathways across the life course. Intern J Pub Health. 2013;58(1):3–11.

    Article  Google Scholar 

  35. Murgatroyd C, Spengler D. Epigenetics of early child development. Front Psychiatry. 2011;2:16.

    Article  PubMed Central  PubMed  Google Scholar 

  36. Juster R-P, McEwen BS, Lupien SJ. Allostatic load biomarkers of chronic stress and impact on health and cognition. Neurosci Biobehav Rev. 2010;35(1):2–16.

    Article  PubMed  Google Scholar 

  37. Fredriksen-Goldsen KI. Health, aging, and sexuality in marginalized communities: LGBT older adults emerging from the margins. Invitational keynote address presented at the 7th Annual Chicago Workshop on Biomarkers in Population-Based Health and Aging Research (CCBAR); Chicago, IL; 2013, October.

    Google Scholar 

  38. Centers for Disease Control and Prevention. Social determinants of health. Atlanta: Centers for Disease Control and Prevention; 2011. http://www.cdc.gov/socialdeterminants/Definitions.html. Accessed 17. Oct. 2012.

  39. U. S. Department of Health and Human Services. Foundation health measures: disparities, healthy people 2020. Washington, DC: U.S. Department of Health and Human Services; 2010. http://www.healthypeople.gov/2020/about/disparitiesAbout.aspx. Accessed 26. Oct. 2011.

  40. Fredriksen-Goldsen KI, Simoni JM, Walters KL, Kim H-J, Lehavot K, Yang J, et al. Reconceptualization of health disparities by sexual orientation and gender identity: LGBTQ Health Equity Model. Am J Orthopsychiatr. 2014;84(6):653–63.

    Google Scholar 

  41. Braveman P. What is health equity: and how does a life-course approach take us further toward it? Matern Child Health J. 2014;18(2):366–72.

    Article  PubMed  Google Scholar 

  42. National Cancer Institute. Alcohol and Cancer Risk. Washington, DC: National Cancer Institute; 2013. http://www.cancer.gov/cancertopics/factsheet/Risk/alcohol. Accessed 17. March 2014.

  43. McCabe SE, Hughes TL, Bostwick WB, West BT, Boyd CJ. Sexual orientation, substance use behaviors and substance dependence in the United States. Addiction. 2009;104(8):1333–45.

    Article  PubMed Central  PubMed  Google Scholar 

  44. Drabble L, Midanik LT, Trocki K. Reports of alcohol consumption and alcohol-related problems among homosexual, bisexual and heterosexual respondents: results from the 2000 National Alcohol Survey. J Stud Alcohol. 2005;66(1):111–20.

    Article  PubMed  Google Scholar 

  45. Deputy NP, Boehmer U. Determinants of body weight among men of different sexual orientation. Prev Med. 2010;51(2):129–31.

    Article  PubMed  Google Scholar 

  46. VanKim NA, Padilla JL. New Mexico’s progress in collecting lesbian, gay, bisexual, and transgender health data and its implications for addressing health disparities. Albuquerque: New Mexico Department of Health; 2010.

    Google Scholar 

  47. Garofalo R, Wolf RC, Kessel S, Palfrey SJ, DuRant RH. The association between health risk behaviors and sexual orientation among a school-based sample of adolescents. Pediatrics. 1998;101(5):895–902.

    Article  CAS  PubMed  Google Scholar 

  48. Substance Abuse and Mental Health Services Administration. Top health issues for LGBT populations information and resource kit. Rockville: Substance Abuse and Mental Health Services Administration, 2012. Contract No.: HHS Publication No. (SMA) 12-4684.

    Google Scholar 

  49. Gruskin EP, Hart S, Gordon N, Ackerson L. Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization. Am J Pub Health. 2001;91(6):976–9.

    Article  CAS  Google Scholar 

  50. Hawkins JD, Catalano RF, Miller JY. Risk and protective factors for alcohol and other drug problems in adolescence and early adulthood: implications for substance abuse prevention. Psychol Bull. 1992;112(1):64–105.

    Article  CAS  PubMed  Google Scholar 

  51. Keyes KM, Hatzenbuehler ML, Hasin DS. Stressful life experiences, alcohol consumption, and alcohol use disorders: the epidemiologic evidence for four main types of stressors. Psychopharmacology. 2011;218(1):1–17.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  52. Bradford J, Reisner SL, Honnold JA, Xavier J. Experiences of transgender-related discrimination and implications for health: results from the Virginia Transgender Health Initiative Study. Am J Pub Health. 2012;103(10):1820–29.

    Google Scholar 

  53. Amadio DM. Internalized heterosexism, alcohol use, and alcohol-related problems among lesbians and gay men. Addict Behav. 2006;31(7):1153–62.

    Article  PubMed  Google Scholar 

  54. Rosario M, Schrimshaw EW, Hunter J. Disclosure of sexual orientation and subsequent substance use and abuse among lesbian, gay, and bisexual youths: critical role of disclosure reactions. Psychol Addict Behav. 2009;23(1):175–84.

    Article  PubMed Central  PubMed  Google Scholar 

  55. Grant JM, Mottet LA, Tanis J, Harrison J, Herman JL, Keisling M. Injustice at every turn: a report of the National Transgender Discrimination Survey. Washington, DC: National Center for Transgender Equality and National Gay and Lesbian Task Force; 2011.

    Google Scholar 

  56. Cochran SD, Keenan C, Schober C, Mays VM. Estimates of alcohol use and clinical treatment needs among homosexually active men and women in the US population. J Consulting Clin Psychol. 2000;68(6):1062–71.

    Article  CAS  Google Scholar 

  57. Eliason MJ. Environmental strategies to address LGBT alcohol, tobacco, and drug use. San Francisco: LGBT-TRISTAR; 2010.

    Google Scholar 

  58. Cole C, Jones L, McVeigh J, Kicman A, Syed Q, Bellis MA. Cut: a guide to adulterants, bulking agents and other contaminants found in illicit drugs. Liverpool: Centre for Public Health; 2010.

    Google Scholar 

  59. Hashibe M, Straif K, Tashkin DP, Morgenstern H, Greenland S, Zhang ZF. Epidemiologic review of marijuana use and cancer risk. Alcohol. 2005;35(3):265–75.

    Article  CAS  PubMed  Google Scholar 

  60. National Cancer Institute. Laboratory/animal/preclinical studies. Bethesda: National Cancer Institute; 2013. http://www.cancer.gov/cancertopics/pdq/cam/cannabis/healthprofessional/page4. Accessed 26. March 2014.

  61. Hunt J. Why the gay and transgender population experiences higher rates of substance use: many use to cope with discrimination and prejudice. Washington, DC: Center for American Progress; 2012.

    Google Scholar 

  62. Cochran BN, Cauce AM. Characteristics of lesbian, gay, bisexual, and transgender individuals entering substance abuse treatment. J Subst Abuse Treat. 2006;30(2):135–46.

    Article  PubMed  Google Scholar 

  63. Ashbee O, Goldberg JM. Trans people and cancer. Vancouver: Transgender Health Program; 2006.

    Google Scholar 

  64. Hatzenbuehler ML, Nolen-Hoeksema S, Erickson SJ. Minority stress predictors of HIV risk behavior, substance use, and depressive symptoms: results from a prospective study of bereaved gay men. Health Psychol. 2008;27(4):455–62.

    Article  PubMed  Google Scholar 

  65. Mereish EH, O’Cleirigh C, Bradford JB. Interrelationships between LGBT-based victimization, suicide, and substance use problems in a diverse sample of sexual and gender minorities. Psychol Health Med. 2014;19(1):1–13.

    Article  PubMed  Google Scholar 

  66. Ryan C, Huebner D, Diaz RM, Sanchez J. Family rejection as a predictor of negative health outcomes in white and Latino lesbian, gay, and bisexual young adults. Pediatrics. 2009;123(1):346–52.

    Article  PubMed  Google Scholar 

  67. Centers for Disease Control and Prevention. Obesity: halting the epidemic by making health easier, at a glance 2011. Atlanta: Centers for Disease Control and Prevention; 2011. http://www.cdc.gov/chronicdisease/resources/publications/aag/obesity.htm. Accessed 7. Dec. 2011.

  68. Valanis BG, Bowen DJ, Bassford T, Whitlock E, Charney P, Carter RA. Sexual orientation and health: comparisons in the women’s health initiative sample. Arch Fam Med. 2000;9(9):843–53.

    Article  CAS  PubMed  Google Scholar 

  69. Boehmer U, Bowen DJ, Bauer GR. Overweight and obesity in sexual-minority women: evidence from population-based data. Am J Pub Health. 2007;97(6):1134–40.

    Article  Google Scholar 

  70. Roberts SA, Dibble SL, Nussey B, Casey K. Cardiovascular disease risk in lesbian women. Womens Health Issues. 2003;13(4):167–74.

    Article  PubMed  Google Scholar 

  71. Yancey AK, Cochran SD, Corliss HL, Mays VM. Correlates of overweight and obesity among lesbian and bisexual women. Prev Med. 2003;36(6):676–83.

    Article  PubMed Central  PubMed  Google Scholar 

  72. Center of Excellence for Transgender Health. General Prevention and Screening San Francisco, CA: University of California Center of Excellence for Transgender Health; 2014. http://transhealth.ucsf.edu/trans?page=protocol-screening#S4X. Accessed 3. April 2014.

  73. Christakis NA, Fowler JH. The spread of obesity in a large social network over 32 years. N Engl J Med. 2007;357(4):370–9.

    Article  CAS  PubMed  Google Scholar 

  74. Fogel S, Young L, Dietrich M, Blakemore D. Weight loss and related behavior changes among lesbians. J Homosex. 2012;59(5):689–702.

    Article  PubMed  Google Scholar 

  75. National Cancer Institute. Risk factors. Washington, DC: National Institutes of Health; 2006. http://www.cancer.gov/cancertopics/wyntk/cancer/page3. Accessed 17. Dec. 2013.

  76. American Society of Clinical Oncology. The role of major nutrients in cancer prevention. Alexandria: American Society of Clinical Oncology; 2012. http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/diet-and-nutrition/role-major-nutrients-cancer-prevention. Accessed 25. March 2014.

  77. Veugelers PJ, Fitzgerald AL, Johnston E. Dietary intake and risk factors for poor diet quality among children in Nova Scotia. Can J Pub Health. 2005;96(3):212–6.

    Google Scholar 

  78. Gates GJ. Food insecurity and SNAP participation (Food Stamps) in LGBT communities. Los Angeles: Williams Institute, UCLA School of Law; 2014.

    Google Scholar 

  79. Bowen DJ, Balsam KF, Diergaarde B, Russo M, Escamilla GM. Healthy eating, exercise, and weight: impressions of sexual minority women. Women Health. 2006;44(1):79–93.

    Article  PubMed  Google Scholar 

  80. Brown SG, Morrison LA, Calibuso MJ, Christiansen TM. The menstrual cycle and sexual behavior: relationship to eating, exercise, sleep, and health patterns. Women Health. 2008;48(4):429–44.

    Article  PubMed Central  PubMed  Google Scholar 

  81. Boehmer U, Bowen DJ. Examining factors linked to overweight and obesity in women of different sexual orientations. Prev Med. 2009;48(4):357–61.

    Article  PubMed  Google Scholar 

  82. American Society of Clinical Oncology. Physical activity and cancer risk. Alexandria: American Society of Clinical Oncology; 2013. http://www.cancer.net/navigating-cancer-care/prevention-and-healthy-living/physical-activity/physical-activity-and-cancer-risk. Accessed 18. March 2014.

  83. Centers for Disease Control and Prevention. Physical inactivity and people with disabilities: a tip sheet for public health professionals. Atlanta: Centers for Disease Control and Prevention; 2010. http://www.cdc.gov/ncbddd/documents/physical-inactivity-tip-sheet-_phpa_1.pdf. Accessed 26. March 2014.

  84. Artaud F, Dugravot A, Sabia S, Singh-Manoux A, Tzourio C, Elbaz A. Unhealthy behaviours and disability in older adults: three-City Dijon cohort study. Br Med J. 2013;347:f4240.

    Article  Google Scholar 

  85. Aaron DJ, Markovic N, Danielson ME, Honnold JA, Janosky JE, Schmidt NJ. Behavioral risk factors for disease and preventive health practices among lesbians. Am J Pub Health. 2001;91(6):972–5.

    Article  CAS  Google Scholar 

  86. Reisner SL, Gamarel KE, Dunham E, Hopwood R, Hwahng S. Female-to-male transmasculine adult health: a mixed-methods community-based needs assessment. J Am Psychiatr Nurses Assoc. 2013;19(5):293–303.

    Article  PubMed  Google Scholar 

  87. Fredriksen-Goldsen KI, Kim H-J, Emlet CA, Muraco A, Erosheva EA, Hoy-Ellis CP, et al. The aging and health report: disparities and resilience among lesbian, gay, bisexual, and transgender older adults. Seattle: Institute for Multigenerational Health; 2011.

    Google Scholar 

  88. Brown MT, Grossman BR. Same-sex sexual relationships in the national social life, health and aging project: making a case for data collection. J Gerontol Soc Work. 2014; 57(2–4):108–29.

    Google Scholar 

  89. Rosario M, Corliss HL, Everett BG, Reisner SL, Austin SB, Buchting FO, et al. Sexual orientation disparities in cancer-related risk behaviors of tobacco, alcohol, sexual behaviors, and diet and physical activity: pooled youth risk behavior surveys. Am J Public Health. 2014;104(2):245–54.

    Article  PubMed Central  PubMed  Google Scholar 

  90. Hatzenbuehler ML, Phelan JC, Link BG. Stigma as a fundamental cause of population health inequalities. Am J Public Health. 2013;103(5):813–21.

    Article  PubMed Central  PubMed  Google Scholar 

  91. Williams DR, Costa MV, Odunlami AO, Mohammed SA. Moving upstream: how interventions that address the social determinants of health can improve health and reduce disparities. J Public Health Manage. 2008;14(Suppl):S8–17.

    Article  Google Scholar 

  92. Elliott S. Absolut celebrates its 30 years of marketing to gay consumers. New York Times [Internet]; (Business Day Media & Advertising). 2011. http://www.nytimes.com/2011/10/27/business/media/absolut-heralds-its-marketing-to-gay-consumers.html?_r=0.

  93. McCabe SE, Bostwick WB, Hughes TL, West BT, Boyd CJ. The relationship between discrimination and substance use disorders among lesbian, gay, and bisexual adults in the United States. Am J Public Health. 2010;100(10):1946–52.

    Article  PubMed Central  PubMed  Google Scholar 

  94. Human Rights Campaign. Employment Non-Discrimination Act. Human Rights Campaign, Washington DC. 2014. http://www.hrc.org/laws-and-legislation/federal-legislation/employment-non-discrimination-act. Accessed 19. May 2014.

  95. Hatzenbuehler ML, Bellatorre A, Lee Y, Finch BK, Muennig P, Fiscella K. Structural stigma and all-cause mortality in sexual minority populations. Soc Sci Med. 2014;103:33–41.

    Article  PubMed Central  PubMed  Google Scholar 

  96. Rostosky SS, Riggle EDB, Horne SG, Miller AD. Marriage amendments and psychological distress in lesbian, gay, and bisexual (LGB) adults. J Couns Psychol. 2009;56(1):56–66.

    Article  Google Scholar 

  97. Eliason MJ, Dibble S, Dejoseph J. Nursingʼs silence on lesbian, gay, bisexual, and transgender issues: the need for emancipatory efforts. ANS Adv Nurs Sci. 2010;33(3):206–18.

    Article  PubMed  Google Scholar 

  98. American Medical Association. AMA policies on GLBT issues: H-65.973 health care disparities in same-sex partner households. American Medical Association, Washington, DC. 2013. http://www.ama-assn.org//ama/pub/about-ama/our-people/member-groups-sections/glbt-advisory-committee/ama-policy-regarding-sexual-orientation.page. Accessed 1. Nov. 2013.

  99. Fisher JD, Cornman DH, Osborn CY, Amico KR, Fisher WA, Friedland GA. Clinician-initiated HIV risk reduction intervention for HIV-positive persons: formative research, acceptability, and fidelity of the options project. J Acquir Immune Defic Syndr. 2004;37(Suppl 2):S78–87.

    Article  PubMed  Google Scholar 

  100. Fisher JD, Fisher WA, Cornman DH, Amico RK, Bryan A, Friedland GH. Clinician-delivered intervention during routine clinical care reduces unprotected sexual behavior among HIV-infected patients. J Acquir Immune Defic Syndr. 2006;41(1):44–52.

    Article  PubMed  Google Scholar 

  101. National Cancer Institute. HPV and cancer. National Institutes of Health, Rockville. 2012. http://www.cancer.gov/cancertopics/factsheet/Risk/HPV. Accessed 11. July 2014.

  102. Epstein S. Sexualizing governance and medicalizing identities: the emergence of ‘state-centered’ LGBT health politics in the United States. Sexualities. 2003;6(2):131–71.

    Article  Google Scholar 

  103. Rofes E. Dry bones breathe: gay men creating post-AIDS identities and cultures. Harrington Park Press: New York; 1998.

    Google Scholar 

  104. Knauer NJ. Navigating a post-Windsor world: the promise and limits of marriage equality. Georget J Gend Law. 2014.

    Google Scholar 

  105. Freedom to Marry. Marriage Litigation. Freedom to Marry, New York. 2014. http://www.freedomtomarry.org/litigation. Accessed 14. July 2014.

  106. Herek GM. Legal recognition of same-sex relationships in the United States: a social science perspective. Am Psychol. 2006;61(6):607–21.

    Article  PubMed  Google Scholar 

  107. Wight RG, LeBlanc AJ, de Vries B, Detels R. Stress and mental health among midlife and older gay-identified men. Am J Public Health. 2012;102(3):503–10.

    Article  PubMed Central  PubMed  Google Scholar 

  108. Wood RG, Goesling B, Avellar S, Mathematica Research. The effects of marriage on health: a synthesis of recent research evidence. U.S. Department of Health and Human Services & Office of the Assistant Secretary for Planning and Evaluation, Washington, DC; 2007.

    Google Scholar 

  109. Hatzenbuehler ML, Pachankis JE, Wolff J. Religious climate and health risk behaviors in sexual minority youths: a population-based study. Am J Public Health. 2012;102(4):657–63.

    Article  PubMed Central  PubMed  Google Scholar 

  110. Ramirez-Valles J, Kuhns LM, Campbell RT, Diaz RM. Social integration and health: community involvement, stigmatized identities, and sexual risk in Latino sexual minorities. J Health Soc Behav. 2010;51(1):30–47.

    Article  PubMed Central  PubMed  Google Scholar 

  111. LIVESTRONG Foundation. Families of choice: sources of support for LGBT cancer survivors. LIVESTRONG Foundation, Austin. 2013. http://blog.livestrong.org/2013/03/25/families-of-choice-sources-of-support-for-lgbt-cancer-survivors/. Accessed 2. April 2014.

  112. Ryan C, Russell ST, Huebner D, Diaz R, Sanchez J. Family acceptance in adolescence and the health of LGBT young adults. J Child Adolesc Psychiatr Nurs. 2010;23(4):205–13.

    Article  PubMed  Google Scholar 

  113. Kaminski PL, Chapman BP, Haynes SD, Own L. Body image, eating behaviors, and attitudes toward exercise among gay and straight men. Eat Behav. 2005;6(3):179–87.

    Article  PubMed  Google Scholar 

  114. Cochran SD, Sullivan JG, Mays VM. Prevalence of mental disorders, psychological distress, and mental health services use among lesbian, gay, and bisexual adults in the United States. J Clin Consult Psychol. 2003;71(1):53–61.

    Article  Google Scholar 

  115. Cochran BN, Peavy KM, Robohm JS. Do specialized services exist for LGBT individuals seeking treatment for substance misuse? A study of available treatment programs. Subst Use Misuse. 2007;42(1):161–76.

    Article  PubMed  Google Scholar 

  116. Nemoto T, Operario D, Keatley J, Nguyen H, Sugano E. Promoting health for transgender women: Transgender Resources and Neighborhood Space (TRANS) program in San Francisco. Am J Public Health. 2005;95(3):382–4.

    Article  PubMed Central  PubMed  Google Scholar 

  117. Nuttbrock L, Bockting W, Rosenblum A, Hwahng S, Mason M, Macri M, et al. Gender abuse, depressive symptoms, and HIV and other sexually transmitted infections among male-to-female transgender persons: a three-year prospective study. Am J Public Health. 2013;103(2):300–7.

    Google Scholar 

  118. Konishi C, Saewyc E, Homma Y, Poon C. Population-level evaluation of school-based interventions to prevent problem substance use among gay, lesbian and bisexual adolescents in Canada. Prev Med. 2013;57(6):929–33.

    Article  PubMed  Google Scholar 

  119. van Wormer K, McKinney R. What schools can do to help gay/lesbian/bisexual youth: a harm reduction approach. Adolescence. 2003;38(151):409–20.

    PubMed  Google Scholar 

  120. Denning P. Practicing harm reduction psychotherapy: an alternative approach to addictions. vol xxv. Guilford Press: New York; 2000. p 262.

    Google Scholar 

  121. Denning P, Little J, Glickman A. Over the influence: the harm reduction guide for managing drugs and alcohol. vol xix. Guilford Press: New York; 2004. p 328.

    Google Scholar 

  122. Massachusetts Department of Public Health. The health of lesbian, gay, bisexual, and transgender (LGBT) persons with their heterosexual and non-transgender counterparts. Massachusetts: Massachusetts Department of Public Health; 2009.

    Google Scholar 

  123. Hendricks ML, Testa RJ. A conceptual framework for clinical work with transgender and gender noncomforming clients: an adaptation of the minority stress model. Prof Psychol: Res Pract. 2012;43(5):460–7.

    Article  Google Scholar 

  124. Bockting WO, Miner MH, Swinburne Romine RE, Hamilton A, Coleman E. Stigma, mental health, and resilience in an online sample of the U.S. transgender population. Am J Public Health. 2013;103(5):943–51.

    Article  PubMed Central  PubMed  Google Scholar 

  125. Szymanski DM, Sung MR. Minority stress and psychological distress among Asian American sexual minority persons. Couns Psychol. 2010;38(6):848–72.

    Article  Google Scholar 

  126. Davis S, Mirick DK. Circadian disruption, shift work and the risk of cancer: a summary of the evidence and studies in Seattle. Cancer Causes Control. 2006;17(4):539–45.

    Article  PubMed  Google Scholar 

  127. Rahman Q, Silber K. Sexual orientation and the sleep-wake cycle: a preliminary investigation. Arch Sex Behav. 2000;29(2):127–34.

    Article  CAS  PubMed  Google Scholar 

  128. American Psychiatric Association, DSM-5 Task Force. Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Arlington: American Psychiatric Association; 2013.

    Book  Google Scholar 

  129. King M, Semlyen J, Tai SS, Killaspy H, Osborn D, Popelyuk D, et al. A systematic review of mental disorder, suicide, and deliberate self harm in lesbian, gay and bisexual people. BMC Psychiatry. 2008;8:70.

    Article  PubMed Central  PubMed  Google Scholar 

  130. Sephton S, Spiegel D. Circadian disruption in cancer: a neuroendocrine-immune pathway from stress to disease? Brain Behav Immun. 2003;17(5):321–8.

    Article  CAS  PubMed  Google Scholar 

  131. Schwappach DL. Smoking behavior, to quit, and preferences toward cessation programs among gay men in Zurich, Switzerland. Nicotine Tob Res. 2008;10(12):1783–7.

    Article  PubMed  Google Scholar 

  132. Remafedi G, Carol H. Preventing tobacco use among lesbian, gay, bisexual, and transgender youths. Nicotine Tob Res. 2005;7(2):249–56.

    Article  PubMed  Google Scholar 

  133. Eliason MJ, Dibble SL, Robertson PA. Lesbian, gay, bisexual, and transgender (LGBT) physicians’ experiences in the workplace. J Homosex. 2011;58(10):1355–71.

    Article  PubMed  Google Scholar 

  134. Eliason MJ, Dejoseph J, Dibble S, Deevey S, Chinn P. Lesbian, gay, bisexual, transgender, and queer/questioning nurses’ experiences in the workplace. J Prof Nurs. 2011;27(4):237–44.

    Article  PubMed  Google Scholar 

  135. Buchmueller T, Carpenter CS. Disparities in health insurance coverage, access, and outcomes for individuals in same-sex versus different-sex relationships, 2000–2007. Am J Public Health. 2010;100(3):489–95.

    Article  PubMed Central  PubMed  Google Scholar 

  136. Cochran SD, Mays VM, Bowen D, Gage S, Bybee D, Roberts SJ, et al. Cancer-related risk indicators and preventive screening behaviors among lesbians and bisexual women. Am J Public Health. 2001;91(4):591–7.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  137. Harcourt J. Current issues in lesbian, gay, bisexual, and transgender (LGBT) health. J Homosex. 2006;51(1):1–11.

    Article  PubMed  Google Scholar 

  138. Kerker BD, Mostashari F, Thorpe L. Health care access and utilization among women who have sex with women: sexual behavior and identity. J Urban Health. 2006;83(5):970–9.

    Article  PubMed Central  PubMed  Google Scholar 

  139. Roberts SJ, Patsdaughter CA, Grindel CG, Tarmina MS. Health related behaviors and cancer screening of lesbians: results of the Boston Lesbian Health Project II. Women Health. 2004;39(4):41–55.

    Article  PubMed  Google Scholar 

  140. Tracy JK, Lydecker AD, Ireland L. Barriers to cervical cancer screening among lesbians. J Womenʼs Health (Larchmt). 2010;19(2):229–37.

    Article  Google Scholar 

  141. Charlton BM, Corliss HL, Missmer SA, Frazier AL, Rosario M, Kahn JA, et al. Reproductive health screening disparities and sexual orientation in a cohort study of U.S. adolescent and young adult females. J Adolesc Health. 2011;49(5):505–10.

    Article  PubMed Central  PubMed  Google Scholar 

  142. Heslin KC, Gore JL, King WD, Fox SA. Sexual orientation and testing for prostate and colorectal cancers among men in California. Med Care. 2008;46(12):1240–8.

    Article  PubMed Central  PubMed  Google Scholar 

  143. Bauer GR, Hammond R, Travers R, Kaay M, Hohenadel KM, Boyce M. “I don’t think this is theoretical; this is our lives”: how erasure impacts health care for transgender people. J Assoc Nurs AIDS Care. 2009;20(5):348–61.

    Article  Google Scholar 

  144. Sanchez NF, Rabatin J, Sanchez JP, Hubbard S, Kalet A. Medical students’ ability to care for lesbian, gay, bisexual, and transgendered patients. Fam Med. 2006;38(1):21–7.

    PubMed  Google Scholar 

  145. Margolies L, Scout N. LGBT patient-centered outcomes: cancer survivors teach us how to care for all. Washington, DC: National LGBT Cancer Network, Network for LGBT Health Equity; 2013.

    Google Scholar 

  146. Gill DL, Morrow RG, Collins KE, Lucey AB, Schultz AM. Perceived climate in physical activity settings. J Homosex. 2010;57(7):895–913.

    Article  PubMed  Google Scholar 

  147. Cahill S, South K, Spade J. Outing age: public policy issues affecting gay, lesbian, bisexual and transgender elders. Washington, DC: National Gay and Lesbian Task Force; 2000.

    Google Scholar 

  148. Metlife Mature Market Institute, American Society on Aging. Still out, still aging: the metlife study of lesbian, gay, bisexual, and transgender baby boomers. New York: Metlife Mature Market Institute and American Society on Aging; 2010.

    Google Scholar 

  149. de Vries B, Mason AM, Quam J, Aquaviva K. State recognition of same-sex relationships and preparations for end of life among lesbian and gay boomers. Sex Res Soc Policy. 2009;6(1):90–101.

    Article  Google Scholar 

  150. U.S. Department of Health and Human Services. Healthy People 2010: lesbian, gay, bisexual, and transgender health: substance abuse. Washington, DC: U.S. Department of Health and Human Services; 2000.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Karen I. Fredriksen-Goldsen PhD .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Fredriksen-Goldsen, K., Hoy-Ellis, C., Brown, M. (2015). Addressing Behavioral Cancer Risks from a LGBT Health Equity Perspective. In: Boehmer, U., Elk, R. (eds) Cancer and the LGBT Community. Springer, Cham. https://doi.org/10.1007/978-3-319-15057-4_4

Download citation

Publish with us

Policies and ethics